The Clinical Analysis Of185Cases Of Ovarian Endometriosis

Object: It is a study on the clinical features, CA125level, clinical stages, treatment andprognosis of OEM and so on.Methods: It has retrospectively analyzed on the clinical data of185patients during thefollow up of OEM from January,2008to January,2010.Result: The time of the follow up of185cases was6to24months. The totalrecurrences were31and the recurrence rate was16.75%. The oldest was52years old andthe youngest was18years old, and there was no prepubertal or postmenopausal woman.There was no statistical meaning between OEM staging and age differences according to theanalysis of variance (P＞0.05). The clinical manifestations were that several symptomscoexisted. There was no statistical meaning between mild group and severe group ofsymptom difference(P＞0.05), and there was a statistical meaning between the symptom andnon-symptom of two groups(P＞0.05). The rate of symptom of severe group was obviouslyhigher than the mild group. The positive rates of different clinical stages of CA125were37.5%of phaseⅠgroup,50%of phaseⅡ group,66.67%of phase Ⅲ group and79.27%ofphase Ⅳ group respectively. The level of serum CA125of severe patients of OEM (phase Ⅲgroup and phase Ⅳ group) was conspicuously higher than the level of mild patients ofOEM(phaseⅠ,Ⅱ)(P＜0.05), while there was no distinct difference between phaseⅠandphaseⅡ(P＞0.05), so was phase Ⅲ group and phase Ⅳ group(P＞0.05); Among the mildpatients of OEM, there were about89.29%, who could preserve the pregnancy ability in theoperation,10.71%who could preserve the ovarian ability, and there was no one of radicaloperation. Among the severe patients of OEM, there were about53.50%, who could preservethe pregnancy ability in the operation,35.03%who could preserve the ovarian ability, and11.47%of radical operation. According to the analysis, there was a statistical meaning forthe selection difference of operation between the mild group and the severe group (P＞0.05).For the mild group, after the operation of preserving pregnancy ability, the recurrence rate ofgroup A was16.67%, B was14.29%, C was16.67%. There was no statistical meaning forthe cases of untreated with GNRHa and untreated group. After the operation of preservingthe ovary function, there was no statistical meaning for the recurrence rate between A andE(P＞0.05). For the severe group, after the operation of preserving pregnancy ability, the recurrence rate of group A was50%, B was33.33%, C was38.46%, D was13.33%. Therewas no statistical difference among group A, B and C, and there was a statistical meaning fordifference of recurrence rate of group C and D. After the operation of preserving the ovaryfunction, there was no statistical meaning for the difference of the recurrence rate of everygroup (P＞0.05). There were18cases that treated with any medicine after radical surgeryand the recurrence rate was11.1%. For the sterility patients after operation of preservingpregnancy ability, the total pregnancy rate was81.36%: the pregnancy rate of group A was50%, group B was71.42%, group C was57.14%, and group D was92.31%. There was astatistical meaning for the difference of pregnancy rate of every group(P＞0.05). Thepregnancy rate of patients who treated with GNRHa after operation was highest. The patientswho treated with medicine after the operation of preserving pregnancy ability, among themild groups, the response rate of symptom of group A was83.33%, group B was85.71%,and group C was83.33%, and there was no statistical meaning for the difference of responserate of three groups; among the severe groups, the response rate of symptom of group A was50%, group B was66.67%, group C was61.54%and group D was86.67%, and there was nostatistical meaning for the difference among groups; The patients who treated with medicineafter the operation of preserving ovarian ability, for the mild groups, the response rate ofsymptom was100%; for the severe groups, group A was66.67%, group B was75%, group Cwas84.62%, and group D was94.12%. There was no statistical meaning for the differenceamong groups(P＞0.05). The severe groups who treated with any medicine after radicalsurgery, the response rate of symptom was88.89%.Conclusion: There are several symptoms coexist for the OEM, and the symptom rate ofsevere groups is higher than the mild groups’; the positive rate of CA125of the severegroups is obviously higher than the mild groups’;according to Laparoscopic intraoperativesituation made rAFS staging, the individual treatment with medicine after operationimproved the prognosis (including the recurrence rate, the pregnancy rate and the responserate of symptom). After the operation of preserving pregnancy ability, there was noobviously difference of the recurrence rate and response rate of symptom for the mild groupswho treated with medicine (such as Sanjiezhentong capsule, Gastrinone and oralcontraceptives); there was obviously improvement effect on the recurrence rate and responserate of symptom for the severe groups who treated with GNRHa; it was helpful forimproving the pregnancy rate for the mild groups who treated with GNRHa. After theoperation of preserving the ovarian ability, there was no statistical meaning for the difference of recurrence rate among mild groups who treated with medicine (such as relief of paincapsule, pregnant three ketene and oral contraceptives); therefore, it is necessary for thepatients treated with medicine after the operation.